| Organization Name: | POTENTIAL MEDICAL SERVICE |
| NPI Number: | 1083636070 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VERONICA D SANDERS (BUSINESS OFFICE MANAGER) |
| Mailing Address: | 2255 Ridge Rd Ste 303 Rockwall |
| State: | TX US |
| Postal Code: | 750875155 |
| Phone Number: | 4696988500 |
| Fax Number: | 4696988504 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZE0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Electroneurodiagnostic |
| Taxonomy Definition: | |